English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

In their recent commentary, Vernillo and coworkers [1] argue that disclosure of a critically ill patient's HIV status to a surrogate is appropriate when 'necessary for the surrogate to make decisions that reflect the patient's values and interests, or when failure to disclose poses direct and foreseeable risks to the surrogate.'  Although few would disagree with the latter precept, the ethical and legal permissibility of the former is less obvious [2]. Dispensing with patient confidentiality under the rubric of 'beneficence' does not guarantee preferable end-of-life outcomes. Even if the emotional impact of this disclosure has minimal influence on surrogates' decision making abilities, they are, ceteris paribus, left no better informed of their loved one's wishes than before.  HIV-infected patients may have various rational reasons for refusing to disclose their seropositivity or declining anti-retroviral treatment, which are unlikely to be easily divined by most critical care teams. What is known about many of these patients is that they have chosen to keep their HIV status confidential, often at great sacrifice. Surmising that they favor 'the timely withdrawal of painful or futile interventions' – precisely when these patients can no longer speak for themselves – both begs the question and stretches the bounds of human inference.  The authors' proposed framework for disclosing privileged information risks positing knowledge of patients' attitudes and beliefs where there is none and threatens the privacy and health care interests of an already vulnerable population. Physicians must ultimately remain vigilant of unwarranted supposition when caring for the critically ill and interacting with their surrogates.

HIV disclosure to surrogate decision makers: privacy versus presumption